VINAYAMay a monk act as a doctor?

Ajahn
Brahmavamso

A recurring misunderstanding standing among some lay
Buddhist is that a monk may practise as a doctor to the
laity. Some monks do become skilled in herbal medicine and
other traditional therapies but when, if ever, are they
allowed by their precepts to behave as a doctor?

The Lord Buddha once said "Whoever, monks, would tend
me, he should tend the sick" and this well known saying
has often used to justify a monk acting as a doctor. However,
the saying is taken out of context as will soon be clear. The
full passage, found in that section of the Vinayapitaka
called the Mahavagga, chapter 8, verse 26, relates to the
story of the Lord Buddha coming across a fellow monk who was
suffering dysentery. With the help of Ven. Ananda, the Lord
Buddha cleaned and settled the sick monk. Shortly afterwards,
the Lord Buddha addressed the Sangha:

"Monks, you have not a mother, you have not a
father who might tend you. If you, monks, do not tend one
another, then who is there to tend you? Whoever, monks,
would tend me, he should tend the sick." (From
the Pali Text Societys translation, Book of the
Discipline, Vol 4 p 432)

The full passage makes it abundantly clear that when the
Lord Buddha said "Whoever would tend me should tend the
sick", His meaning was for monks to look after fellow
monks who were sick. He was not referring to monks acting as
doctors to the laity.

In fact, the Lord Buddha said several times that acting as
a doctor to lay people is, for a monk, Wrong Livelihood
(miccha-ajiva) directly contrary to the fifth factor of the
Noble Eightfold Path and a Debased Art (tiracchana-vijja).
For example, in the very first Sutta in the first collection
of Suttas, being the Brahmajala Sutta of the
Digha Nikaya, the Lord Buddha said:

27. "Whereas some recluses and brahmins while
living on the food offered by the faithful, earn their
living by a wrong means of livelihood (miccha-ajiva), by
such debased arts (tiracchana-vijja) as: promising gifts
to deities in return for favours; fulfilling such
promises; demonology; reciting spells after entering an
earthen house; inducing virility and impotence; preparing
and consecrating sites for a house; giving ceremonial
mouthwashes and bathing; offering sacrificial fires;
administering emetics, purgatives, expectorants and
phlemagogues; administering ear medicine, eye medicine,
nose medicine, collyrium and counter ointments; curing
cataracts, practising surgery, practising as a
childrens doctor; administering medicines to cure
bodily diseases and balms to counter their after effects
-- the recluse Gotama (the Lord Buddha) abstains from
such wrong means of livelihood, from such debased
arts." (From The Discourse on the
All-Embracing Net Views , p 61, being the
Buddhist Publication Society of Kandys English
edition of the Brahmajala Sutta)

Thus the Lord Buddha clearly condemned any monk who makes
his living by behaving as a doctor to the laity.

The tradition that has come down to all Theravada Buddhist
monks is that described in the Samantapasadika, the great
commentary on the Vinayapitaka compiled by Buddhaghosa in Sri
Lanka in the 5th century C.E. This authoritative work states
that a monk may prescribe and supply medicines to his fellow
monastics (monks and nuns), to his parents or to those
looking after his parents, and to any laypeople staying in
the monastery of Vihara either preparing to go forth as monks
of just staying to help the monks. Also, a monk may prescribe
but not buy medicines to his brothers and sisters, aunts and
uncles, grandparents and to whatever travellers, bandits,
people wounded in battle and those without relatives who come
to the monastery of Vihara for emergency help. Should a monk
prescribe or supply medicines beyond his allowance, he
commits an offence against his precepts (a dukkata
offence). Further, if he prescribes of supplies a medicine to
a layperson for a material gift in return, then he incurs
another offence against his precepts for "corrupting
families" (kuladusaka). That is what is stated in
the Samantapasadika Vinaya Commentary, respected in all
Theravada Buddhist countries. The passage may be found in the
Pali Text Societys edition of the Samantapasadika page
469f (unfortunately this work is in Pali and no English
translation is available yet.

This answer from the authoritative texts to the question
"May a monk act as a doctor?" shows a wise balance
which recognises a monks duty to his parents, his
responsibilities to those monks and laypeople staying with
him in his monastery, and his compassion to all those
visiting his monastery for emergency help. It prevents in any
circumstances receiving any material reward for such
services. Moreover, it remembers that the role of a Buddhist
monk towards the laity is not to act as a doctor to the body
but to act as a kind sage, a doctor to the mind.